Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2021; 13(5): 453-461
Published online May 15, 2021. doi: 10.4251/wjgo.v13.i5.453
Sex as an effect modifier in the association between alcohol intake and gastric cancer risk
Jong-Myon Bae
Jong-Myon Bae, Department of Preventive Medicine, Jeju National University College of Medicine, Jeju-si 63243, Jeju, South Korea
Author contributions: Bae JM performed to select related articles, conduct statistical analysis, and write the paper.
Conflict-of-interest statement: The author declares no conflict of interests and no funding sources for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jong-Myon Bae, MD, PhD, Full Professor, Department of Preventive Medicine, Jeju National University College of Medicine, 102 Jejudaehka-ro, Jeju-si 63243, Jeju, South Korea. jmbae@jejunu.ac.kr
Received: November 27, 2020
Peer-review started: November 27, 2020
First decision: February 14, 2021
Revised: February 22, 2021
Accepted: April 13, 2021
Article in press: April 13, 2021
Published online: May 15, 2021
ARTICLE HIGHLIGHTS
Research background

The previous systematic reviews showed a statistically significant association between alcohol intake and gastric cancer risk in men. However, women did not have statistical significance in any of the meta-analyses.

Research motivation

The author hypothesized that alcohol intake’s association with gastric cancer risk may differ between men and women.

Research objectives

The aim was to investigate the suggested hypothesis targeting four previous meta-analyses by performing a meta-epidemiological review.

Research methods

After securing additional cohort studies meeting the selection criteria, updated meta-analysis and subgroup analysis by sex were conducted.

Research results

The subgroup analysis of the 13 men’s cohorts showed that there was statistical significance in Asians, in the group with a high level of adjustment for smoking status, in the group with the adjustment for body mass index, and in more recently published studies. These results were not found in the seven women’s cohorts.

Research conclusions

The present study suggests that alcohol consumption increases the risk of gastric cancer in men.

Research perspectives

It is necessary to re-estimate the follow-up outcomes by stratification for sex to determine whether there is a sex difference in the association between alcohol intake and gastric cancer risk.